Can magnifying endoscopy with narrow-band imaging discriminate between carcinomas and low grade adenomas in gastric superficial elevated lesions?

Abstract Background and study aims We aimed to evaluate the diagnostic performance of magnifying endoscopy with narrow-band imaging (M-NBI) in superficial non-ampullary duodenal epithelial tumors (SNADETs) regarding the absence or presence of biopsy before M-NBI diagnosis. Patients and methods Clinicopathological data were retrospectively reviewed for 99 SNADETs from 99 patients who underwent endoscopic resection. The 99 tumors were divided into the non-biopsy group (32 lesions not undergoing biopsy before M-NBI examination) and the biopsy group (67 lesions undergoing biopsy before M-NBI examination). We investigated the correlation between the M-NBI diagnosis and the histopathological diagnosis of the SNADETs in both groups. Results According to the modified revised Vienna classification, 31 tumors were classified as category 3 (C3) (low-grade adenoma) and 68 as category 4/5 (C4/5) (high-grade adenoma/cancer). The accuracy, sensitivity, and specificity of preoperative M-NBI diagnoses in the non-biopsy group vs the biopsy group were 88 % (95 % confidence interval: 71.0 – 96.5) vs 66 % (51.5 – 75.5), P = 0.02; 95 % (77.2 – 99.9) vs 89 % (76.4 – 96.4), P = 0.39; and 70 % (34.8 – 93.3) vs 14 % (3.0 – 36.3), P < 0.01, respectively. Notably, in the biopsy group, the specificity of M-NBI in SNADETs was low at only 14 % because we over-diagnosed most C3 lesions as C4/5. M-NBI findings might have been compromised by the previous biopsy procedure itself. Conclusions In the non-biopsy group, the accuracy of M-NBI in SNADETs was excellent in distinguishing C4/5 lesions from C3. The M-NBI findings in SNADETs should be evaluated while carefully considering the influence of a previous biopsy.

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Erratum to: Can magnifying endoscopy with narrow band imaging be useful for low grade adenomas in preoperative biopsy specimens?

Gastric Cancer ◽

10.1007/s10120-015-0470-7 ◽

2015 ◽

Vol 18 (2) ◽

pp. 446-446 ◽

Cited By ~ 1

Author(s):

Kazuhiro Miwa ◽

Hisashi Doyama ◽

Renma Ito ◽

Hiroyoshi Nakanishi ◽

Katsura Hirano ◽

...

Keyword(s):

Narrow Band ◽

Narrow Band Imaging ◽

Magnifying Endoscopy ◽

Low Grade ◽

Biopsy Specimens ◽

Preoperative Biopsy

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Magnifying endoscopy with narrow-band imaging is useful in the differential diagnosis between low-grade adenoma and early cancer of superficial elevated gastric lesions

Gastric Cancer ◽

10.1007/s10120-012-0160-7 ◽

2012 ◽

Vol 16 (2) ◽

pp. 140-146 ◽

Cited By ~ 42

Author(s):

Shinichiro Maki ◽

Kenshi Yao ◽

Takashi Nagahama ◽

Takahiro Beppu ◽

Takashi Hisabe ◽

...

Keyword(s):

Differential Diagnosis ◽

Narrow Band ◽

Early Cancer ◽

Narrow Band Imaging ◽

Magnifying Endoscopy ◽

Low Grade ◽

Gastric Lesions

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EFFICACY OF THE DIAGNOSTIC ACCURACY USING MAGNIFYING ENDOSCOPY WITH NARROW-BAND IMAGING FOR PURE SIGNET RING CELL CARCINOMA AND POORLY DIFFERENTIATED-TYPE COMPONENT MIXED WITH UNDIFFERENTIATED-TYPE ADENOCARCINOMA

10.1055/s-0040-1704295 ◽

2020 ◽

Author(s):

M Inuyama ◽

Y Horiuchi ◽

J Fujisaki

Keyword(s):

Diagnostic Accuracy ◽

Narrow Band ◽

Narrow Band Imaging ◽

Signet Ring Cell Carcinoma ◽

Signet Ring Cell ◽

Magnifying Endoscopy ◽

Signet Ring ◽

Undifferentiated Type ◽

Poorly Differentiated ◽

Ring Cell

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Endoscopic submucosal dissection by using Clutch cutter and IT knife 2 for early gastric cancer with severe submucosal fibrosis: a case report

MedPharmRes ◽

10.32895/ump.mpr.2.3.17 ◽

2018 ◽

Vol 2 (3) ◽

pp. 17-21

Author(s):

Nhan Le ◽

Phuong Vien ◽

Nghia Le

Keyword(s):

Gastric Cancer ◽

Early Gastric Cancer ◽

Endoscopic Submucosal Dissection ◽

Narrow Band ◽

Narrow Band Imaging ◽

Magnifying Endoscopy ◽

Gastrointestinal Cancers ◽

Pathological Result ◽

Well Differentiated ◽

Submucosal Fibrosis

Introduction: Gastric cancer is one of the highly malignant gastrointestinal cancers and the third leading cause of cancer death. In the last decade, early gastric cancer (EGC) has been reported by using narrow-band imaging (NBI) magnifying endoscopy. Advances in endoscopic techniques, such as endoscopic submucosal dissection (ESD), have enabled the en bloc resection of these EGC. Although ESD is performed for early gastric cancer, there are still many difficult problems in technique of this procedure. The difficulty of gastric ESD depends on the size and location of a tumor, presence of severe submucosal fibrosis, presence of ulceration... We report a case of our successful ESD by using Clutch cutter and IT knife 2 in treatment of EGC with severe submucosal fibrosis. Case presentation: A 62-year-old man felt an epigastric discomfort two months ago. The narrow-band imaging (NBI) magnifying endoscopy revealed a suspected early gastric cancer type 0 - IIa + IIc (Japanese classification of early gastrointestinal cancers) at the incisura angularis, the size of this lesion was 15 mm in diameter, and pathological result of endoscopic biopsy was a well-differentiated adenocarcinoma. ESD was performed and we found there was severe submucosal fibrosis which was dissected safer and faster by using Clutch cutter and IT knife 2. There were no complications such as severe bleeding and perforation. The size of resected specimen was 60 x 35 mm and the time of procedure was 150 minutes. After ESD, the pathological result was a well differentiated adenocarcinoma, pT1a, UL(-), LY(-), V(-), no cancer cell in vertical and horizontal margins. The healing time of ESD-induced ulcer was 5 weeks without local recurrence. Conclusion: Through this case, we aim to emphasize the importance of using Clutch cutter and IT knife 2 as a modified technique which makes ESD a safe procedure in treatment of EGC with severe submucosal fibrosis.

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